Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 5th Edition Systemic Lupus Erythematosus (SLE) Case Studies  A 24-year-old woman had been complaining of multiple joint and muscular pains and stiffness in the morning. She also noted some hair loss and increased skin sensitivity to light. Her physical examination showed slight erythema around the cheek bones and some swelling in the joints of her hands. StudiesResultsRoutine laboratory workWithin normal limits (WNL), except for mild anemiaUrinalysis, p. 956Profuse proteinuria and cellular castsAntinuclear antibody (ANA), p. 881:256 (normal: <1:20)Anti-DNA398 units (normal: <70 units)Anti-ENAPositive (normal: negative)Anticardiolipin antibody (ACA), p. 68  Immunoglobulin (Ig) G 96 g/L (normal: <23 g/L) IgM78 mg/L (normal: <11 mg/L)Erythrocyte sedimentation rate (ESR), p. 22175 mm/hour (normal: =20 mm/hour)Immunoglobulin electrophoresis, p. 312 IgG1910 mg/dL (normal: 565-1765 mg/dL)IgA450 mg/dL (normal: 85-385 mg/dL)IgM475 mg/dL (normal: 55-375 mg/dL)Total complement assay, p. 17222 hemolytic units/mL (normal: 41-90 hemolytic units/mL) Diagnostic Analysis The positive ANA and ACA tests strongly supported the diagnosis of systemic lupus erythematosus (SLE). The patient also had a facial rash suggestive of SLE. The elevated ESR indicated a systemic inflammatory process. The immunoelectrophoresis results were compatible with either RA or SLE; however, a decreased complement assay is commonly associated with SLE. The abnormal urinalysis indicated that the kidneys also were involved with the disease process. The patient was treated with steroids and did well for 7 years. Unfortunately, her renal function deteriorated, and she required chronic renal dialysis. Critical Thinking Questions Explain the significance of the urinalysis results as they relate to renal involvement with SLE.Why is the ESR increased in inflammatory conditions? Health Science Science Nursing MSN 5700 Share QuestionEmailCopy link Comments (0)

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